Effectiveness of a screening programme in identifying individuals with increased risk of cardiovascular disease in South Africa.

Background: To determine the proportion of participants identified with previously undiagnosed diabetes and untreated hypertension in the Heart and Stroke Foundation South Africa's screening programme.

Methods: This cross-sectional study was conducted nationally in 2013 among ≥18-year-old adults self-selected for screening. Data collection included medical history and behaviours related to diet, physical activity, smoking and alcohol use. Clinical measurements comprised blood pressure, anthropometry and point-of-care random blood glucose and cholesterol assessments.

Results: Among the 7711 participants, 2488 men and 5223 women, mean ages were 47.6 years and 48.6 years, respectively. Prevalence of diabetes was 13.8% in men and 12.8% in women but only 1.8% (45) and 0.9% (47), respectively, were newly diagnosed. Another 14.5% (men) and 12.4% (women) had impaired glycaemia. Only 32.9% and 36.3% with known diabetes were controlled. Hypertension was prevalent in 51.8% of men and 48.9% of women, 52.0% and 63.1% of whom were using anti-hypertensive medication; 43.2% of men and 45.5% of women on anti-hypertensive medication were controlled.

Conclusions: Very few individuals with newly diagnosed diabetes were identified, which underscores the need for cost-effective targeted screening of high-risk individuals to optimize diagnosis. Furthermore, the suboptimal levels of diabetes and hypertension control highlights the need for improved care.